Regulation wins a cheering section

Cheerleader injury

Ben Woloszyn, Chicago Tribune

Madeline “Maddie” Dardanes, a sophomore at the University of Illinois at Urbana-Champaign, works out her leg at the Campus Activities and Recreation Center. While a varsity cheerleader at Barrington High School, she suffered a torn ligament in her knee during a routine.

Madeline “Maddie” Dardanes, a sophomore at the University of Illinois at Urbana-Champaign, works out her leg at the Campus Activities and Recreation Center. While a varsity cheerleader at Barrington High School, she suffered a torn ligament in her knee during a routine. (Ben Woloszyn, Chicago Tribune)

When Madeline "Maddie" Dardanes was a varsity cheerleader at Barrington High School, she suffered a torn ligament in her knee during a routine — and tumbled into a growing statistic that is getting more attention from doctors and safety advocates, who want cheerleading classified as a sport.

Now a sophomore at the University of Illinois at Urbana-Champaign, Dardanes recalls "landing really weird" in what she called "a round-off, flip-flop, full." An MRI revealed that she had a full tear of her anterior cruciate ligament.

That type of injury is just one of many that doctors say participants in the ever-growing and competitive cheerleading world are prone to suffer. They also get fractures, sprains, strains, and breaks in their knees, ankles, elbows and wrists. Less common, but still prevalent, are severe concussions, skull fractures and other head, neck and back injuries that can topple a young person's future.

"Cheerleading ranks up there with hockey and football in terms of catastrophic injuries," said Jeff Mjaanes, a sports medicine specialist at Rush University Medical Center in Chicago. In fact, he said cheerleading poses more risk than playing football.

Mjaanes recently co-wrote a policy statement in the American Academy of Pediatrics that calls for a nationwide recognition of cheerleading as a sport. The designation would guarantee cheerleaders receive the same medical attention as other athletes, and require annual physical examinations before they're allowed to participate.

It would also ensure access to better facilities with equipment such as safe floor mats and other essentials. And it would also require oversight of coaches and trainers.

Illinois and 28 other states already classify high school cheerleaders as athletes, garnering them that extra level of safety through regulation. Increasingly popular cheerleading gyms, however, have a set of rules they are encouraged — but not required — to follow.

Even though she was considered an athlete when she tore the ligament, since she was in a high school program, Dardanes recognizes how important it is for cheerleading to have the careful oversight that regulation as a sport brings.

"I definitely think (cheerleading) should be a sport," Dardanes said. "It's so hard on your body and on your mind. ... You have to put in the same amount of work as you do other sports. I don't understand why it is still being debated."

Cheerleading has been considered a sport by the Illinois High School Association for eight years, and governed as such. But not all organizations that sponsor cheerleading necessarily fall under such guidelines.

Mjaanes said there are approximately 30,000 "significant injuries" to cheerleaders in the United States reported each year. Though fewer in number, there are at least five "catastrophic injuries" reported each year — such as skull fractures, brain bleeds and cervical spine injuries that can lead to paralyses.

"I have seen some (concussions) that even go on to post-concussion syndrome ... symptoms last for months, chronic headaches, depression, school difficulties, trouble remembering things and concentrating," Mjaanes said.

Mjaanes called the current approach to governing cheerleading "haphazard," and the policy statement he co-wrote recommends that all cheerleading be recognized as an official sport by each state at all levels — including teams fielded by competitive gyms, park districts and schools from elementary through college.

Mjaanes also wants records collected for all cheerleading injuries in a national database, as they are with other sports.

Laura Meehan, head cheerleading coach at Barrington High School, said cheerleading at her school is treated as a sport and follows guidelines set by the National Federation for High Schools. Barrington began doing that before the Illinois High School Association categorized cheerleading as a sport.

Once the state recognized cheerleading as a sport, Meehan said there has been "increased medical treatment and supportive athletic training staff (provided) to give the kids treatment."

That includes more medical staff available to cheerleaders at practices, IHSA sponsored games and competitions, she said.

Guidelines are set and followed to keep the cheerleaders safe and are routinely revised by the NFHS. For example, last spring, the NFHS outlawed doing more than one twist in a stunt, she said.

Meehan said her coaching team regularly goes through safety courses specific to cheerleading "required and recommended" by the NFHS, such as CPR. The coaching staff regularly reviews the rules of cheerleading and goes through a course each year dealing with the signs and treatment of concussions.

"All states need to get on board," Meehan said.

"Coaches could be a random teacher that has no experience or knowledge of the sport, and no understanding of the rules and requirements," she said. "...This causes safety issues. People not familiar with a sport are coaching it and kids are getting hurt."

In some competitive gyms, where winning competitions is everything and risky stunts are getting trickier and more daring to impress judges, a different set of guidelines are followed. They're set by the United State's All Star Federation. But there's no requirement that the gyms follow the guidelines.

Ultimate Athletics in Wauconda trains more than 500 cheerleaders, ages 2 to 19, for stiff cheer competitions where winning trophies and becoming a national name is the goal.

Gym owner Michelle Reisdorf said she thinks that cheerleading has been unfairly deemed a dangerous sport and has recently been receiving some negative press.

"Cheerleading, when properly managed, is not a dangerous sport," Reisdorf insisted. "When you have credentialed and trained coaches, it's no more dangerous than any other sport out there."

Reisdorf sees few injuries in her facility and that, she said, is because her qualified coaches focus on conditioning, mastering basic skills, mentally and physically, before moving on to more advanced skills in both tumbling and stunting.

Coaches do not advance cheerleaders to higher level teams unless they have mastered certain lower level stunts, she said.

Should a cheerleader fall or get hurt, all activity is halted in the gym and the on-site athletic trainer intervenes, assesses the situation and provides necessary treatments and exercises.

"Cheerleading, like any other sport has risks associated with it," Reisdorf said. "Each practice may have a few bumps and bruises, but serious injuries are not common at UA."

Reisdorf said cheerleading is an evolving sport.

"There wasn't all-star cheer in our day ... in high school," she said. "Now, we still build pyramids, but things are added to them like flips."

The sport of cheerleading itself has evolved like any other sport, like football and basketball. The difference, she said, is that those sports have been around a lot longer. Cheerleading, especially competitive all-star cheerleading is always evolving in coaching, skills, stunts and safety, Reisdorf said.

"The importance of safety has grown within our sport. ... Now we are a sport, we are a team, we compete, now there is a federation that has rules," she said.

Reisdorf, the Illinois state director of the USASF, said the answer is not as simple as including competitive gyms under the rules for high school cheerleaders.

"We would not support being governed by high school rules — not because there is anything wrong with them, but because we simply offer a different product that deserves its own set of rules," she said.

Almost all competitive gyms are members of the USASF, according to Reisdorf. But even if they are not, they still have to follow USASF rules at any USASF sanctioned competition. She noted that parents should ask if their gym is a member of the USASF.

"It's a little more flashy and the skills and the stunts are extremely harder to do," she said. "To prepare our girls we make sure they are prepared physically, but mentally ready as well."

She said raising the bar is common in the all-star cheerleading world.

"The nature of the sport is a little more flashy, it's daring, it's edgy," Henderson said. "It's very competitive. As the years go on you see gyms coming up with bigger and better tricks. So of course, if you want to be the best, you have to be able to compete with the best. More tricks, more passes, more flip-flopping, these kids have to be conditioned well."